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Aspects of life new to the aging phase: Aspects of life new to the aging phase: –Increasing number of losses to death –Search for meaning in our living Most older adults become more involved in improving society Most older adults become more involved in improving society –Become more compassionate to the needs of others –Perceive it as a time to become closer to family and friends Some stagnate and become excessively concerned with their own needs, self-absorbed and egocentric Some stagnate and become excessively concerned with their own needs, self-absorbed and egocentric Erik Eriksons stages: Erik Eriksons stages: –Integrity vs despair Facing end of the life with satisfaction, fulfillment Facing end of the life with satisfaction, fulfillment Facing life with feeling of missed opportunities or directions Facing life with feeling of missed opportunities or directions

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Suicide in Old Age The risk of suicide grows with age The risk of suicide grows with age Each year 6,300 older adults (mostly male) Each year 6,300 older adults (mostly male) Possible reasons Possible reasons –People living longer with chronic illness –Social isolation –Accumulation of multiple losses –Loss of parental and work roles –Lessening of activity

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Chronic illness Chronic illness –Physiological and psychological declines –Depression and diagnosis of terminal illness –Increased passivity and loneliness –Lack of meaning because of a reduction in purposeful activity Multiple losses Multiple losses –Rapid succession of losses (job, status, spouse, peers, good health, social freedom) –Often results in depression – most common illness in the elderly Alcoholism Alcoholism –Alcohol abuse enhances depression and exacerbates negative life events –Bereaved adults experience a significant increase in alcohol consumption Death of a spouse Death of a spouse –Loneliness and a need for companionship –Widows are usually able to cope better than widowers

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Loss and Mourning in Old Age The Death of a Pet The Death of a Pet –Pets as companions –Talking to and stroking a pet promotes relaxation and lowers blood pressure –Life with a pet linked to higher survival rates in patients with heart disease, increased self-confidence and independence in psychiatric patients –Animal assisted therapy programs –Effective medium for increasing socialization –Increased sense of purpose and self-esteem –Grief after death of a pet but also not being able to care for a pet, what happens to the pet if they die

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Loss and Mourning in Old Age The Death of an Adult Child The Death of an Adult Child –Survivor guilt - Often they would prefer death to that of their child –Sometimes little social recognition of their loss, since child’s spouse and children are the ones in primary grief –Difficulty in grieving process of children with AIDS, especially homosexuals The Death of a Spouse The Death of a Spouse –Rumination over the death (tendency to think about and relive memories, repeatedly) associated with higher and longer depression –Spouse’s recovery from grief is quicker and more complete when the marriage was happy –Spouse’s from unhappy marriage have longer and more complicated grief – feelings of guilt, unfinished business, unresolved anger

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The broken heart syndrome The tendency of one elderly spouse, usually male, to die shortly after the death of the other The tendency of one elderly spouse, usually male, to die shortly after the death of the other Beck’s cognitive distortion model – cognitive triad of negative thoughts Beck’s cognitive distortion model – cognitive triad of negative thoughts –Misinterpretation of facts in a negative way –Focus on the negative aspects of any situation –Pessimistic and hopeless expectations about future Learned Helplessness Learned Helplessness –Problems as internal or external –Global-specific continuum –Stable (chronic) or unstable (acute)

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The broken heart syndrome Psychodynamic perspective Psychodynamic perspective –Consequence of separation of a child from an important figure during early childhood –Correlation between loss of mother in childhood and adult depression The humanistic – existential perspective The humanistic – existential perspective –Loss of self-esteem in the here and now –Collapse of the individual’s sense of self as a result of death of his/her spouse

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Aging, Empowerment, and Meaning As elders, we crease new definitions of wellness, learn to empower ourselves As elders, we crease new definitions of wellness, learn to empower ourselves Graying America Graying America –1 in 100 of those born 1979 to 1981 will reach 100 years of age –In 2025 there will be more people over 65 in the world than current total population of Europe and North America

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Aging, Empowerment, and Meaning Aging, Beauty, and the Body Aging, Beauty, and the Body –Those who place importance on their body image experience more depression and anxiety associated with aging –People who place importance on non-physical attributes (intelligence, interpersonal skills, etc.) feel young and accept the inevitable physical decline –Shift from valuing physical powers to valuing wisdom and relationships –Health-oriented response patterns among aging Americans Health vigilants (believe that diet, vitamins, and execise can conquer virtually any health threat) Health vigilants (believe that diet, vitamins, and execise can conquer virtually any health threat) True believers (illness is best to be resisted through positive thinking, faith, prayer, optimism and friendship) True believers (illness is best to be resisted through positive thinking, faith, prayer, optimism and friendship) Fatalists (believe that their health is determined by fate and luck or genes and they can not influence it) Fatalists (believe that their health is determined by fate and luck or genes and they can not influence it)

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Self-esteem and empowerment in old age Social breakdown syndrome (SBS) – negative adjustment in old age (Kuypers & Bengtson, 1973) Social breakdown syndrome (SBS) – negative adjustment in old age (Kuypers & Bengtson, 1973) 1.An existing susceptibility to psychological breakdown 2.Labeling of the older person as incompetent or deficient by family or doctors 3.Induction into a sick role 4.Identification with the sick role Empowerment Empowerment –Process of helping people to feel a sense of control over their lives to counter SBS Changing stereotypes and beliefs of aging person Changing stereotypes and beliefs of aging person Developing valued roles for elders at home, hospital and community Developing valued roles for elders at home, hospital and community

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Empowerment through wellness Wellness Wellness –Active process of living in which persons strive to achieve a sense of balance and integration among their mind, body and emotions –Focus on self-responsibility –Physical, psychological, and spiritual well- being –Most importantly – assuming responsibility for our own well-being

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Coming to terms with Death: Motifs of Meaning Death as an organizer of time Death as an organizer of time –Those who talk about ‘time remaining’ have more favorable attitudes toward life Death as a fear to be conquered Death as a fear to be conquered –Those who talk about death, make concrete preparations for death, have achieved their goals, and are religious have less anxiety of death Death as punishment and loss Death as punishment and loss –Young people perceive death as loss of opportunity to experience things –Older people perceive death as loss of time to complete their inner work Death as counterpoint Death as counterpoint –Expanded appreciation of everyday moments